The primary objective of the project is to increase accrual of African American and other underserved patient populations in Southeastern North Carolina (SENC) onto NCI-sponsored clinical trials. The ultimate goal at the completion of the five-year grant funding period will be for NHRMC to apply to become a minority-based Community Clinical Oncology Program (MB-CCOP) or standard CCOP by achieving the required annual patient accrual rates for these programs. Based upon the current patient population, NHRMC would not be able to eligible to apply for MB-CCOP status. African Americans comprise approximately 25% of the total patient population in SENC as well as at ZCC specifically, far short of the 40% minority population required to be eligible for MB-CCOP application. However, inclusion of Hispanic and poor White patients results in a total of approximately 38-40% underserved population. In either case, whether MB-CCOP or standard CCOP status is sought, the addition of cancer prevention and symptom management studies as well as three planned investigator-initiated studies described herein will greatly enhance the likelihood that this goal is achieved. Secondary program objectives will be to: 1) Sustain and grow a robust clinical trials infrastructure;2) Increase the number of oncologists both in the community and in the academic partner institutions that are actively involved in clinical research that specifically addresses underserved populations;3) Continue to break down barriers to cancer care for the underserved via an increasingly independent patient navigation program.